Jordan Fuller, DO | |
61 Dolphin Dr, Treasure Island, FL 33706-3113 | |
(727) 241-3248 | |
Not Available |
Full Name | Jordan Fuller |
---|---|
Gender | Male |
Speciality | Hospitalist |
Experience | 8 Years |
Location | 61 Dolphin Dr, Treasure Island, Florida |
Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679922678 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | OS15231 (Florida) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Baycare Home Care Inc | Largo, FL | Home health agency |
Phoebe Home Health | Albany, GA | Home health agency |
St Anthonys Hospital | Saint petersburg, FL | Hospital |
Phoebe Putney Memorial Hospital | Albany, GA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Bayside Medical Group Llc | 9931325990 | 6 |
Phoebe Physician Group Inc | 8426112350 | 342 |
Entity Name | Bayside Medical Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215353818 PECOS PAC ID: 9931325990 Enrollment ID: O20140728001785 |
Mailing Address | Practice Location Address |
---|---|
Jordan Fuller, DO 61 Dolphin Dr, Treasure Island, FL 33706-3113 Ph: () - | Jordan Fuller, DO 61 Dolphin Dr, Treasure Island, FL 33706-3113 Ph: (727) 241-3248 |
Dr. Peter Michael Pardoll, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 34 Paradise Ln, Treasure Island, FL 33706 Phone: 727-422-5464 Fax: 727-360-5352 | |
Chris Carson, M.D. Internal Medicine Medicare: May Accept Medicare Assignments Practice Location: 61 Dolphin Dr, Treasure Island, FL 33706 Phone: 727-954-0671 Fax: 727-825-1354 |